OP RHTE# »o 15f -39f K Harnett County Department of Public Health 19981
PERMIT # Operation Permit
New Installation Septic Tank ❑ Repalr,*~ Nitrification Line ❑ Expansion
PROPERTY LOCATION:
Name: (owner) ~ ij SUBDIVISION +t LOT #
System Installer.
~Ir
Registration #
Basement with plumbing. El Garage 14, Number of Bedrooms
Type of Water Sully: ❑ ommunity ja, Public ❑ Well Duan e m well _ feet
System Tyre: J- a t< Types Y 'and VI Systems expire years.
(In accordance with Table V z) Owner must act Health Department 6 months prior to expiration for permit renewal.
ms tem his WO 003W m compiance "th Math Carolina General Statutes, kiss for krar h MWn xW and canditian of the emem Pemrt and fansstKUOn Audarirapon
J~
PERMIT Mummnii.
I. Performance:
II. Monitoring.
III. Maintenance:
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other.
IV. Operation:
V. Other.
Subsurface system operator required? Yes ❑ Noi
If yes, see attached sheet for additional operation conditions, maintenance and reporting
Following are the specifications for the sewage disposals em on the above ptioned property.
Type of system: El Conventional [~ther Size of tank: Septic Tank: - f gallons Pump Tank: gallons
Subsurface No. of 1 xact length width of depth of
Drainage field ditches 1 of each ditch - awl- feet ditches- feet ditches inches
French Drain Required: linear feet
Authorized State Agent Date 01,